The Chinese drinking problem: a review of the literature and its implication in a cross-cultural study

Alcoholism as a problem has never been widely understood in Chinese society. The rarity of alcoholism in Chinese society may be due to marked sensitivity to alcohol, associated with high levels of acetaldehyde, in this population. In addition, sociocultural reasons such as alcoholic beverages generally being consumed only at parties and during mealtimes, strong social sanctions against drunkards and drunken behavior, and the presence of a strong Confucian moral ethic, have accounted for the drinking behavior of Chinese individuals. However, there is evidence that alcohol consumption and the prevalence of alcoholism have skyrocketed in the past 40 years in Taiwan. Social and cultural changes may be expected to affect the incidence and prevalence of alcoholism and other mental disorders in terms of changes in a traditional culture, and social integration-disintegration. Differences in methodology for case identification, and the fact that Chinese alcoholic patients do not seek psychiatric treatment primarily for drinking problems, are also considered to account for some of the discrepancy between the actual rate and the lower identified rate of alcoholism. It can also be speculated that the low rate of alcoholism in psychiatric settings depends largely on the attitudes of patients, their families, and the general public towards drinking problems. Hence, this paper will review the theories and compare epidemiologic data about drinking problems in Chinese individuals, and then point to areas for future research.